Thesis (M.S.)--Ohio University, August, 2004. / Title from PDF t.p. Includes bibliographical references (p. 75-81)

Thesis (Ph. D.)--University of British Columbia, 2005. / Includes bibliographical references (leaves 305-337). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (Ph. D.)--University of British Columbia, 2005. / Includes bibliographical references (leaves 305-337).

This study was designed to investigate the relative contributions of cognitive level, age, and verbal ability to the prediction of children's concepts of health and illness. The rationale for the study was based on the premise that children's cognitive developmental level would have relevance when preparing programs for child health education. The sample consisted of 40 subjects ranging in age from 5 to 13 years who were already participants in the Preadmission Preparation Programs Study, a research project being conducted at B.C.'s Children's Hospital in Vancouver. There were 10 children selected from each of four age groups: 5-6; 7-8; 9-10; and 11-13. The subjects were administered a Health Questionnaire and a battery of Piagetian tasks representing both the concrete operational and formal operational stages of cognitive development. Verbal ability was measured by the Peabody Picture Vocabulary Test - Revised (PPVT-R). In a stepwise multiple regression equation, with level of health concept as the criterion variable and cognitive level, age, and verbal ability as the predictor variables, it was hypothesized that, (1) cognitive level would be a stronger predictor of level of health concept than the predictors of age and verbal ability, (2) cognitive level together with age would be a stronger predictor than either index on its own, and (3) verbal ability would account for a significant portion of the variance with regard to level of health concept over and above that already accounted for by cognitive level and age. The expected entry sequence into the prediction equation was cognitive level on step 1, age on step 2, and verbal ability on step 3. The results indicated that all three predictor variables, taken individually, were significantly correlated with the criterion variable; however, the expected entry sequence of variables into the prediction equation and the expected net effect of combined variables were not supported by the data analyses. Age was selected for entry on step 1 and verbal ability was selected for entry on step 2; cognitive level was not selected to enter the prediction equation. When forced into the equation on step 3, cognitive level contributed a negligible additional amount of variance to the efficacy of prediction. Although cognitive level correlates highly with level of concept, when the effects of age are partialed out, the contribution of cognitive level is not significant. Given some of the limitations of the study, small sample size and restricted range of scores for level of health concept and for the Piagetian assessment, it was suggested that in a further study with a greater representation of formal operational thinkers, there may be more support for the hypotheses. Directions for future research were discussed in terms of conducting a similar study with a sample that has a good representation of both concrete and formal operational thinkers so that the prediction strength of cognitive level can be tested within a restricted age limit. Another suggestion was that research focus on the interaction of specific cognitive concepts with health concepts to provide a greater understanding of the developmental sequence of conceptualization of health and illness. Implications for child health education were discussed in terms of knowledge of cognitive developmental level enabling medical personnel to communicate more effectively with children and plan appropriate intervention strategies for them. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

No description available.

Health-case costs in the United States have been rising at an alarming pace. Therefore, a great deal of emphasis has been placed on finding more cost-effective methods of providing care and maintaining health. An area that warrants investigation is the potential for reducing inappropriate utilization of medical-care resources for relatively minor self-limiting problems. One method of accomplishing this is to provide the proper encouragement, skills, and resources to enable individuals to appropriately involve themselves in self-care activities. A study was conducted to determine if an intervention involving self-care information would change participants' beliefs and attitudes concerning responsibility and involvement in their own health care. Students entering the Student Health Service at the University of Arizona during the study period were randomly assigned to the treatment group or control group. Members of the treatment group received the intervention and were asked to complete a survey instrument. Members of the control group were asked to complete the survey instrument only. The survey instrument consisted of a measurement of attitudes toward information and behavioral involvement in health care (i.e., Krantz Health Opinion Survey) and a measure of beliefs regarding one's ability to exert control over their health (i.e., Multidimensional Health Locus of Control). Also on the instrument was a measure of the individual's behavioral intentions regarding projected use of medical-care practitioners. Results of the study indicated that the intervention was able to change the treatment group's attitudes regarding a greater preference for more active involvement in their health care. Also subsequent to the intervention, the treatment group's responses reflected less of a belief that health was outside of their control. No difference was found between the treatment and control group in regard to behavioral intentions. These results demonstrate that a positive change in health-related beliefs and attitudes can come about as a result of a relatively uncomplicated and inexpensive intervention.

No description available.

Breast cancer (BC) survivors are at increased risk of cancer recurrence, a second cancer, and non-cancer comorbidities. Previous studies suggest that many women adopt a spontaneous change in lifestyle after a BC diagnosis in hope of achieving a better survival outcome. While this observation has led to the suggestion that a BC diagnosis is a “teachable moment” for improving health behaviors, other conflicting studies report that BC survivors do not make positive changes in health behaviors following a breast cancer diagnosis. Although previous studies suggest that receipt of cancer chemotherapy and hormonal therapy is associated with weight loss or weight gain, the association between post-diagnosis weight change with changes in lifestyle has not been studied in detail. The majority of prior studies of post-diagnosis changes in behavior and weight have examined the mean change between two time points, and therefore may over simplify the trajectory of change over time due to lack of more granular data. New methods are needed to examine the distribution and correlates of behavior/weight trajectories following the BC diagnosis. In my dissertation, a systematic literature review was conducted to evaluate the evidence regarding the frequency, magnitude and pattern of post-diagnosis changes in diet [fruit/vegetable (F/V), dietary fat], physical activity [moderate to vigorous physical activity (MVPA) and sedentary behaviors], alcohol intake, and body weight among BC survivors. A total of 66 studies were included in the systematic review. These studies suggest that after a breast cancer diagnosis, women are less likely to engage in MVPA and more likely to reduce alcohol intake. Previous studies suggested that women may experience weight change after a BC diagnosis, although there were strong evidence showing both weight gain and weight loss were common. The reports of changes in diet and sedentary behavior following a BC diagnosis are limited and inconclusive about the direction of change. The results of the review suggested that there is wide variation in post-diagnosis lifestyle changes among BC survivors. However, very few studies have investigated the variability in multiple behavior trajectories following a BC diagnosis. In this dissertation, I made use of a population of 4,505 women newly diagnosed with a BC and enrolled in the Kaiser Permanente Northern California Pathways Study. I used a combination of statistical methods, including a semi-parametric, group-based trajectory modeling and a non-parametric K-means for longitudinal data analysis, to identify latent trajectories groups that are unobserved clusters of individuals following similar trajectories of a behavior. These analyses tested the hypotheses that in the 24 months following a breast cancer diagnosis, women follow a mixture of lifestyle (F/V, dietary fat, MVPA, sedentary behavior, alcohol) and body mass index (BMI) trajectories, which can be stable, temporarily increase or temporarily decrease. My analysis identified multiple distinct trajectories of lifestyle behaviors and BMI during the first 24 months after a BC diagnosis. The trajectory analysis results suggest that the large majority of women maintained their lifestyles following a BC diagnosis. Socioeconomic status, dispositional optimism, perceived social support, and the severity of CIPN during active treatment were associated with the post-diagnosis trajectories of. Furthermore, the BMI trajectories were stable over the first 24 months following a BC diagnosis. The BMI trajectories were associated with trajectories of F/V, dietary fat intake, MVPA, sedentary behavior and alcohol intake over the same period, independent of demographic characteristics, tumor characteristics and cancer treatment received. In summary, previous studies suggest that women may spent fewer time on MVPA and drink less alcohol after a BC diagnosis, while both weight gain and loss are common post diagnosis. In a trajectory analysis of 4505 BC survivors enrolled in the Pathways Study, I did not observe any latent trajectory of meaningful change in health behavior or BMI in the first 24 months after a BC diagnosis in the Pathways Study. Instead, my analysis suggests that most women maintained their body weight following a BC diagnosis. The BMI trajectories were strongly associated with trajectory of F/V, dietary fat intake, MVPA, sedentary behavior, and alcohol intake over the same period, independent of demographic characteristics, tumor characteristics and receipt of cancer therapies. These results suggest that there is an absence of spontaneous changes in lifestyle behaviors after BC diagnosis and the importance of maintaining a healthy lifestyle in weight management after a BC diagnosis. Future studies should examine the associations of these health behaviors and BMI trajectories and BC prognosis to better understand the effect of post-diagnosis changes in lifestyle and weight on BC-specific and all-cause mortality.

The purpose of this study was to explore relationships between selected variables of fifth- and eighth-grade students in two school districts regarding advice for health behavior and actual health behavior. The total number of fifth-grade students who participated in the study was 120, and the total number of eighth-grade students who participated in the study was 152. Data were collected through quantitative methods, using two instruments, The Health Self-Determinism Index for Children and How Often Do You? The analysis revealed no differences between male and female students in their advice for health behavior. No difference was found between fifth-grade and eighth-grade students regarding their advice for health behavior. Also, no difference was noted between genders and grade levels and their advice for health behavior. A difference was noted between boys and girls and between fifth- and eighth-grade students regarding advice for health behaviors. A weak, but significantly negative, relationship between advice for health behavior and actual health behavior in male and female fifth- and eighth-grade students was noted in the study. Girls indicated significantly better actual health behaviors than boys. Eighth-graders indicated significantly better health behaviors than fifth-graders. Based on the findings of the study, recommendations for additional research related to children and their health behaviors were suggested. Studies with children could be conducted with individuals of various cultural orientations, comparisons of children and their parents, and children at different stages of their development as related to health behavior. Improvement of professional practice may involve action research as new information and techniques are incorporated into actual practice. Coordinated efforts of health care providers and educators could be effective in assessing and monitoring health behaviors in children.